Systematic review and meta-analysis of anti-thymocyte globulin dosage as a component of graft-versus-host disease prophylaxis.

Rabbit anti-thymocyte globulin (ATG) has been used in allogeneic hematopoietic stem cell transplantation (Allo-HSCT) for graft-versus-host disease (GvHD) prophylaxis. Since the best dose has not been defined yet, this study aimed to determine the efficacy and safety of different doses of ATG in Allo-HSCT. Data sources were MEDLINE/PUBMED, EMBASE, Cochrane Library, Web of Science, LILACS, and SciELO. Studies were eligible when comparing doses of ATG. The higher dose was in the intervention group. A total of 22 articles (2002-2022) were included. Higher doses (4-12 mg/kg) of ATG-T reduced the incidence of grade III-IV acute GvHD (RR 0.60; 95%CI 0.42-0.84) and limited chronic GvHD (RR 0.64 95%CI 0.45-0.92) compared with lower doses (2-7.5 mg/kg). Higher doses increased the Epstein-Barr virus (RR 1.90 95% CI 1.49-2.42) and Cytomegalovirus reactivation (RR, 1.30; 95% CI 1.03-1.64). Relapse rates were higher in the higher dose group (RR 1.34, 95% CI 1.07-167). The ATG-T dose ≥7mg/kg versus the lower dose showed a number needed to treat 7.4 for acute GvHD III-IV, with a number to harm of 7.7 for relapse at one year in the higher dose group. A dose lower than 7 mg/kg suggests a better risk-benefit ratio than a higher one. Well-designed RCT is needed to define the best risk-benefit doses. Trial registration: Trial registration number: PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020173449.

Benefícios das práticas integrativas e complementares no cuidado de enfermagem / Benefits of integrative and complementary practices in nursing care / Beneficios de las prácticas integrativas y complementarias en el cuidado de enfermería

Objetivo: caracterizar os benefícios das práticas integrativas e complementares no cuidado de enfermagem. Método: revisão integrativa realizada nas bases de dados Scielo, Lilacs, PudMed e BVS. Os descritores de busca foram terapias complementares, cuidados em enfermagem, enfermagem holística, toque terapêutico, acupuntura, fitoterapia, aromaterapia, homeopatia. Encontrou-se 4421 artigos disponíveis nos idiomas Português, Espanhol e Inglês; publicados entre os anos 2006 e 2018. Destes foram selecionados 21 artigos. Resultados: entre os benefícios das práticas integrativas foi evidenciado o relaxamento e bem estar, alívio da dor e da ansiedade, diminuição de sinais e sintomas de doenças, estimula o contato profissional-paciente, redução do uso de medicamentos, fortalecimento do sistema imunológico, melhoria da qualidade de vida e diminuição de reações adversas. Considerações finais: É preciso protagonismo empoderamento e preparo da enfermagem para a implementação das PICs em sua prática diária qualificando as práticas assistenciais e reduzindo os custos hospitalares. (AU)

Objective: to characterize the benefits of integrative and complementary practices in nursing care. Method: integrative review in the SciELO, Lilacs, PudMed and Virtual Health Library databases. The search descriptors were Complementary Therapies, Nursing Care, Holistic Nursing, Therapeutic Touch, Acupuncture, Phytotherapy, Aromatherapy and Homeopathy. There were 4421 articles available in Portuguese, Spanish and English published between the years 2006 and 2018. Of these, 21 articles were selected. Results: the benefits of integrative practices showed relaxation and well-being, relief of pain and anxiety, reduction of signs and symptoms of diseases, stimulation of professional-patient contact, reduction of medication use, strengthening of the immune system, quality of life and reduction of adverse reactions. Final considerations: it is necessary to lead, empower and prepare nursing for the implementation of ICPs in their daily practice, qualifying care practices and reducing hospital costs.(AU)

Objetivo: caracterizar los beneficios de las prácticas integrativas y complementarias en el cuidado de enfermería. Método: revisão integrativa realizada nas bases de dados SciELO, Lilacs, PudMed y BVS. Los descriptores de búsqueda fueron Terapias Complementarias, Cuidados en Enfermería, Enfermería Holística, Toque Terapéutico, Acupuntura, Fitoterapia, Aromaterapia, Homeopatía. Se encontró 4421 artículos disponibles en portugués, español e Inglés; publicados entre los años 2006 y 2018. De ellos se seleccionaron 21 artículos. Resultados: los beneficios de las prácticas integrativas fueron evidenciados por la relajación y el bienestar, alivio del dolor y la ansiedad, disminución de signos y síntomas de enfermedades, estimula el contacto profesional-paciente, reducción del uso de medicamentos, fortalecimiento del sistema inmunológico, calidad de vida y disminución de las reacciones adversas. Consideraciones finales: Es necesario protagonismo, empoderamiento y preparación de la enfermería para la implementación de las PICs en su práctica diaria calificando las prácticas asistenciales y reduciendo los costos hospitalarios.(AU)